Vulvovaginitis is an inflammation of the vulva (vulvitis) and vagina (vaginitis) that may occur at any age and affects most females at some time. Because of the proximity of these two structures, inflammation of one usually precipitates inflammation of the other. The prognosis is good with treatment.
Common causes of vaginitis (with or without consequent vulvitis) include the following:
Infection with Trichomonas vaginalis, a protozoan flagellate that is usually transmitted through sexual intercourse
Infection with Candida albicans, a fungus that requires glucose for growth
Bacterial vaginosis (previously known by various names such as Gardnerella vaginalis, Haemophilus vaginalis, and nonspecific vaginitis), which is characterized by a decrease in lactobacilli with a concomitant increase in anaerobic bacteria
Venereal infection with Neisseria gonorrhoeae (gonorrhea), a gram-negative diplococcus
Viral infection with genital warts (Condylomata acuminata) or herpes simplex virus type 2, which are usually transmitted by intercourse
Common causes of vulvitis (with or without consequent vaginitis) include the following:
Parasitic infection (Pthirus pubis, or crab lice), traumatic injury, or poor personal hygiene
Chemical irritations or allergic reactions to hygiene sprays, douches, detergents, clothing, or toilet paper
Retention of a foreign body such as a tampon
Vaginal mucosal atrophy in menopausal women increases the risk for bacterial invasion because of decreasing estrogen levels.
Inflammation and edema may affect the perineum. Skin breakdown may lead to secondary infection.
Signs and symptoms may vary according to the infecting organism:
A patient with trichomonal vaginitis may have vaginal irritation and itching along with urinary symptoms, such as burning and frequency. Inspection may reveal vaginal discharge that’s thin, bubbly, green tinged, and malodorous.
A patient with candidal vaginitis may report intense vaginal itching and a thick, white, cottage-cheese-like discharge. Red, edematous mucous membranes with white flecks may be seen on the vaginal wall.
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